We retrospectively reviewed the hospital records of patients with early gastric carcinoma to compare the clinicopathologic findings in young (age < 40 years, n = 72) and older (age > 70 years, n = 51) patients during the period 1991-2000. Overall survival was the main outcome measure. There was a significant difference in depth of invasion; carcinoma invaded the mucosal layer in 65.3% of the young patients and in 39.2% of the older patients (P < 0.05). The 5-year survival rates of young and older patients did not differ statistically (97.2% versus 94.5%; P = 0.254). The prognosis of young patients with early gastric carcinoma was similar to that of older patients with early gastric carcinoma, and the belief that the prognosis of gastric carcinoma in young patients is poorer than in aged patients should be abandoned. Early detection is most important to achieve the good prognosis.